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Thursday, February 7, 2013

Grapefruit: Adverse Interactions with Medication

Many medications have adverse interactions with grapefruit
(photo from www.diabetesmine.com)

Eat a grapefruit for breakfast. It sounds like a healthy suggestion, doesn't it? For many, the health benefits
of grapefruit are obvious. Grapefruits are high in vitamin C to boost the
immune system, have high levels of antioxidants to ward off cancer, contain
high water levels for a flavorful hydration option, and even have fat-burning
enzymes. Less obvious, however, are the potentially adverse interactions that can come from eating a grapefruit or drinking grapefruit juice while on certain medications prescribed by your
doctor.

First, realize that the reference to “certain medications”
is extremely broad. The list of drugs that have dangerous grapefruit interactions is longer than most people may expect it to
be. Millions of Americans are taking these common medications. That fact, along with a statistic from WebMD stating that
one fifth of Americans have grapefruit for breakfast, is startling. Hopefully,
the people taking those medications know about
grapefruit interactions and are not part of that 20 percent.

How Does it Interact?

So what does
grapefruit do that makes it react so negatively with a considerable number
of drugs? According to WebMD, it interferes
with how the body breaks down certain drugs due to a chemical it contains called
furanocoumarin. The result is that the medication stays in your body for too
short or too long, rendering it either useless or unsafely potent.

More specifically, research cited on ABC News suggests that furanocoumarins block enzymes in the
intestines that break down medications in a normal metabolic process. It only
takes one grapefruit or one glass of grapefruit juice to impede this important
process for more than 24 hours. Because of this, taking your medications hours
apart from when you normally consume grapefruit does not prevent the
interaction. You may simply need to cut this acidic fruit out of your diet
altogether. Fruits with similar interactions are Seville oranges, limes, and
pomelos.

Ignoring this precaution about grapefruit medication interactions is not a wise idea. Drugs that
note sudden death as a possible side effect could be made lethally potent from
the effects of grapefruit. The
chances of sudden death would be exacerbated by an interaction, basically
causing an overdose of the drug. Other side
effects of grapefruit interaction include heart rhythm irregularities,
trouble breathing, kidney failure, blood clots, and muscle breakdown.

For quick reference, ABC News has a list
of 43 specific drugs known to interact with grapefruit. Generally, WebMD lists
the following types of medications as posing a possible threat when grapefruit
is co-ingested:

Statins (cholesterol-lowering drugs)

Antihistamines

Calcium channel blockers (blood pressure drugs)

A variety of psychiatric drugs (including the popular
Zoloft)

Immune suppressants

Pain medications (such as Methadone)

Impotence drugs for erectile dysfunction (such as Viagra)

Anti-HIV medication

Anti-arrhythmic medications

You may not want to limit your concern to these drugs or
even this fruit, though. There are plenty of other food-drug interactions you may not be aware of. It’s important to consult a doctor or pharmacist any time
you are prescribed a new medication. Don’t panic; just be sure to ask about any food-drug interactions associated with what you were prescribed.

Above all, please don’t take these interactions lightly or
ignore any warnings expressed on your prescription bottles or voiced directly
to you by your doctor. Researchers feel that patients and even members of the
medical community take food-drug interactions much less seriously than interactions
involving medications taken with other medications. Unfortunately, both types
have dangerous side effects and require some physician responsibility and
consumer awareness. Improperly used, even a healthy fruit like grapefruit can
cause a great deal of harm. Be informed about your prescriptions and the diet
you follow while taking them.